Nakai Y, Sonobe M, Takigawa T, Yamazaki T, Okamoto S, Sugita K, Matsumaru Y
Department of Neurosurgery, Mito National Hospital; Ibaraki, Japan -
Interv Neuroradiol. 2004 Mar 30;10 Suppl 1(Suppl 1):161-6. doi: 10.1177/15910199040100S128. Epub 2008 Jun 9.
Acute angiographical changes for preventing acute rebleeding on GDC treated cerebral aneurysms were evaluated. From December 2000 to November 2002, 48 total aneurysms in 44 consecutive patients with acute SAH. Acute angiographical evaluations were carried out in 46 aneurysms, including 42 ruptured and 4 unruptured aneurysms. Two cases were excluded because of poor medical condition. In this series, there were no rebleeding cases in acute stage. In the initial embolization for the 46 aneurysms, CO was achieved in eight aneurysms, NR in 15 aneurysms and BF in 23 aneurysms. Acute angiographical observations showed progressive thrombosis in 17 aneurysms (37%). No changes were observed in remaining 29. No recanalization was observed in this series. Only one case of BF, inside the aneurysm bleb was still observed during follow up. Additional embolization was carried out. Progressive thrombosis was frequently observed in GDC treated cerebral aneurysms during acute stage. This angiographical finding seems to show prevention of rebleeding, which is considered important for the management of GDC treatment in acutely ruptured cerebral aneurysm.
对使用GDC治疗的脑动脉瘤预防急性再出血的急性血管造影变化进行了评估。从2000年12月至2002年11月，连续44例急性蛛网膜下腔出血患者共48个动脉瘤。对46个动脉瘤进行了急性血管造影评估，其中包括42个破裂动脉瘤和4个未破裂动脉瘤。2例因病情不佳被排除。在该系列中，急性期无再出血病例。在对46个动脉瘤进行的初始栓塞中，8个动脉瘤实现了完全闭塞（CO），15个动脉瘤实现了近完全闭塞（NR），23个动脉瘤实现了部分栓塞（BF）。急性血管造影观察显示17个动脉瘤（37%）有进行性血栓形成。其余29个动脉瘤未见变化。该系列中未观察到再通。随访期间仅1例BF病例，动脉瘤小泡内仍有造影剂充盈，遂进行了额外栓塞。在急性期，GDC治疗的脑动脉瘤中经常观察到进行性血栓形成。这一血管造影结果似乎显示了对再出血的预防作用，这被认为对急性破裂脑动脉瘤的GDC治疗管理很重要。
